Waiting for cataract surgery is frustrating!

Published in Cataract Basics

Waiting for cataract surgery is frustrating!

The most frustrating time for folks diagnosed with cataract is ... waiting for it to get worse!  Because cataracts generally progress slowly, there is always a gap between the initial diagnosis and when a cataract requires surgery.  It is frustrating to be told that “You cataract is worse.  It is the reason for your blurry vision but it is not yet enough for cataract surgery.”  

There are a number of factors at play here.  e.g. benefit vs. risk, wait lists, payor, driving requirements, visual demands, visual acuity.

It is not uncommon for folks to wish their cataracts worse on each visit!

Read more...

My eyesight is getting better?! How can I have a cataract?

Published in Cataract Basics

My eyesight is getting better?!   How can I have a cataract?

Initial vision improvement with cataract is very common but counterintuitive.

Cataract development will often cause a shift in your prescription before the lens goes very cloudy.   This shift if often (but not always) towards nearsightedness.

Think about the range of all prescriptions like a number-scale with farsightedness on one side of the scale and nearsightedness on  the other side.  Zero/perfect is in the middle.  If you were quite farsighted for all of your life and your cataracts are causing a nearsighted shift… the shift cancels out some of your old prescription bringing you closer to zero/perfect.   You will see better without your glasses than perhaps you have in years!...  until of course the cataract gets denser and starts to cloud your vision.

Some eye care professionals refer to this shift as “second sight”.  Again, “second sight” occurs when the prescription shift caused by the cataract is opposite to your pre-existing Rx.

Read more...

When should I do cataract surgery?

Published in Cataract Pre-Surgery Questions

When should I do cataract surgery?

There is no exact answer here.   The factors that are typically considered are :

1] Visual Acuity.  
Albeit low risk, there are risks involved with cataract surgery.  The benefit of the surgery has to exceed the risk.  A decision to proceed with cataract removal is based on many factors but in general terms, most surgeons in this area will discourage a patient from proceeding until visual acuity falls below 20/50-ish.

2] Visual Demands and motivation
If you are a retiree and spend a limited amount of time at a computer, your visual demands may make it acceptable for you to tolerate less-than-perfect best vision.   If you are working as e.g. a full-time accountant or transport truck driver, your high visual demands would require you get cataract surgery sooner.
Some folks are just simply queasy about eyes and have low motivation to proceed.  You can procrastinate with cataract surgery (most) without worry however there will likely be a point where the procedure simply needs to be done (e.g. failed driving requirements)

3] Status of other eye
If you see well from your other (no or low cataract) eye.   There may be less rush to a surgical solution.

4] Driving status / Caregiver status
If you have a standard driver’s license or a special license or if you are caregiver to others… these things should be taken into consideration for when to do cataract surgery.

5] Symptomology
Years of looking in eyes has taught me that you cannot always predict someone’s symptoms based on the objective look of the cataract.   Some folks have minor cataract changes but are devastated by the blurry vision.  Others have what objectively appears as a advanced cataract, but are getting along fine with their day-to-day lives.    With low symptomology, a surgeon is much less like to proceed.

6] Interest in enhanced refractive improvement
For a patient to consider the increased expenses of enhanced cataract procedures, they are generally going to be highly motivated and anxious to proceed as soon as possible.

7] Secondary ocular health factors
There are some eye conditions where removing cataract early is important.  If the surgery is left too long, there is greater risk for a poorly placed or dislodged implant.  Your doctor will tell you if you have a condition that requires early cataract surgery.

8] Payor
Albeit a controversial topic, payors can influence decisions when cataract surgery is done: Personally funded vs. co-funded vs. government-funded vs. third-party funded
Payors also ultimately influence the type of cataract surgery: Basic vs. enhanced (premium or astigmatic or multifocal implants)

9] Large prescription swing of one eye
As a cataract develops it can cause a large shift in a prescription.  E.g. If one eye experiences a dramatic nearsighted shift the imbalance will not likely be tolerable and cause issues that are hard to fix with glasses.   The recommended solution is to restore the right/left balance through surgery to one or both eyes).

Read more...

What are the common symptoms of cataract?

Published in Cataract Basics

What are the common symptoms of cataract?

Folks experience different symptoms of cataract depending on the degree, location, one-side/both sides.  Your visual demands and other ocular issues also play a major role in visual symptoms.

The most common cataract-related symptoms that patients report are slowly increased glare and blurry vision.    There is not pain or irritation associated with cataract folks often report awareness like a film over the eye.

Constant cleaning of your glasses does not help!

Read more...
Subscribe to this RSS feed